With the rise of digital technologies being a physician in the 21st century has become an extremely demanding job with multiple challenges. They have to cope with a growing number of chronic diseases, recurring administrative tasks as well as cost decisions. Moreover, they face the problem of an ever-growing population (rising life expectancy) while the number of people able to work is decreasing. The number of patients and people in need of care will continue to rise in the coming years. By 2025, an additional 80,000 full-time employees will probably be needed in the medical services of hospitals. At the same time, the number of people who are capable of working will decline. The shortage of skilled personnel will intensify, and it will become more difficult to cover the corresponding personnel requirements. Labour-saving technical digital innovations will be indispensable to relieve the burden on doctors and nursing staff.
While doctors have to perform all the above tasks in their daily work they are also pressed to use new emerging technologies that should relief them of redundant and recurring duties. At the same time new IT systems and programs are often buggy in the beginning and cause for frustration on the physicians’ side and even worse: it limits the time for interaction with patients.
Reading all this, it is not surprising that
every second doctor suffers from burnout
according to the American Medical Association. Physicians cited “too many bureaucratic tasks”, “spending too many hours at work” and “increasing computerization of practice” as the main reasons for their burnouts.
So far it seems as digital technologies have been more of a benefit for patients as for physicians.
Physicians even consider the increasing computerisation as one of the main causes of burnout. But today and in the future there is no way around the use of digital technologies in medicine. These technologies are already fundamentally changing the treatment of patients’ diseases. Patients are more enlightened than ever before, both through their own research on the Internet and through exchanges with each other on social media. These topics are not taught to prospective doctors in medical curricula so far. They still convey the image of the doctor as a demigod who hides his well-guarded information in an ivory tower and decides on the treatment of his patients as an uplifted being.
In practice, the rude awakening comes quickly: Doctors face patients who are actively involved in the treatment process and want to be fully informed — the so called e-patient.
The “e” has several meanings in this context and can either stand for:
- “electronic” the patients uses digital tools and technologies to manage his disease or her health
- “equipped” the patient has digital tools at his disposal
- “enabled” the patient has access to the information he needs regarding his or her health status
- “empowered” the patient is on an eye-to-eye level with the doctor based on access to information and the digital tools at hand
- “engaged” the patient is taking active part in his or her healthcare process
- “expert” the patient is educated, can discuss this health status with the doctor and takes actions in his or her healthcare process
With the changing expectations of patients the role of physicians also needs to transform.
Doctors are no longer the guardians of information locked in the ivory tower of medicine. Their role must change in a way so they offer their patients guidance in abundance of information. They should not simply interpret and explain information, but should refer their patients directly to high-quality information and services so that patients can actively participate in the process. At the same time, physicians, like patients, need to be digitally empowered to use their vision, knowledge and insights in order to make the best decisions for their patients treatment.
The same “e” have to be applied for doctors by giving them digital tools and technologies that really support them in doing their job. Here are some ideas how the use of digital technologies should benefit doctors and support them in their daily routines:
- “electronic” Doctors use digital technologies in their daily routines at ease
- “equipped” Doctors have efficient tools and programs at hand that help them treat their patients
- “enabled” Doctors can use digital tools without to worry about regulations and guidelines
- “empowered” Doctors use tools and technologies that support them in their daily jobs while these tools save them time and effort in their patients treatment. Doctors are empowered to focus on their patients — not on redundant and recurring tasks.
- “engaged” Doctors are empathetic towards their patients. They are actively involving them in the treatment process and fully educating them about their health status. They understand the point of view of their patients and give them relevant feedback.
- “expert” Doctors can use digital tools in order to manage the treatment process of their patients. They know exactly which technologies to use in order to achieve the best outcomes.
Putting these ideas into practice also requires a number of specific skills such as face-to-face communication skills, understanding how to handle digtal literature, interdisciplinarity, knowing where to find information online, translating and interpreting data into useful insights for patients. These skills have so far not been teached in any medical curicula. In addition, the bureaucratic, economic, political, financial and technological burdens do not yet make life easier for doctors. This is also the reason why technological changes have so far been perceived as additional work rather than relief. Only when tools and technologies are self-explanatory and error-free should they be integrated into doctors’ everyday work. Then they have the potential to really add value and help doctors revolutionize the way they work and create time for what is really important: interacting with patients and saving lives.
A Coherent and Trustworthy Health Network for All: Digital Health Strategy 2018–2022. Copenhagen, Denmark: Ministry of Health, Denmark; 2018. Jan 21, [2019–03–04].
How the e-patient community helped save my life: an essay by Dave deBronkart. BMJ. 2013 Apr 2; 346():f1990.